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Dr. Malcolm Mandela Lee , MD, PHD(C), CLS(AAB)

Specialist - Research Study β€’ Park Forest, IL

Active NPI 1659805521 Individual Practitioner Male Practitioner
Practice location in NPPES

344 Victory Dr
Park Forest, IL 604662003

Call 7084903340 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

344 Victory Dr

Park Forest, IL 604662003

Telephone 7084903340
Organization at the Same NPPES Address or Phone
Matthew T. Johnson Md, Pc Facility NPI 1144386202

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2017

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Park Forest and Illinois

1 active clinicians are listed under Specialist - Research Study with a practice address in Park Forest, IL (12 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-08-05
Specialist - Research Study Primary Specialty

NUCC Taxonomy Code: 1744R1102X

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
NPI 1568643864

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

20 Historical Events
πŸ‘€
Provider Name / Credentials Updated August 05, 2024

Recorded as MALCOLM LEE, MD, PHD(C), CLS(AAB)

πŸ“
Updated Practice Location March 04, 2024

Registered at 344 VICTORY DR, PARK FOREST, IL 604662003 (Tel: 7084903340)

πŸ“
Updated Business Mailing Address March 04, 2024

Registered at 344 VICTORY DR, PARK FOREST, IL 604662003 (Tel: 7084903340)

πŸ‘€
Provider Name / Credentials Updated March 04, 2024

Recorded as MALCOLM LEE, MD, CLS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 04, 2024

Specialist

πŸ“
Updated Practice Location September 13, 2021

Registered at 21237 S LA GRANGE RD STE 5, FRANKFORT, IL 604232047 (Tel: 7084903340)

πŸ‘€
Provider Name / Credentials Updated September 13, 2021

Recorded as MALCOLM LEE, MBBS, CLS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 13, 2021

Clinical Medical Laboratory (license number reported to NPPES: IL 10847788)

πŸ“
Updated Practice Location September 21, 2020

Registered at 48 BROOK PARK LN, PARK FOREST, IL 604662642 (Tel: 7087318444)

πŸ“
Updated Business Mailing Address September 21, 2020

Registered at 48 BROOK PARK LN, PARK FOREST, IL 604662642 (Tel: 7087318444)

πŸ‘€
Provider Name / Credentials Updated September 21, 2020

Recorded as MALCOLM LEE, PHLEBOTOMIST

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 21, 2020

Radiology (license number reported to NPPES: IL 1659805521)

πŸ“
Updated Practice Location September 30, 2019

Registered at 277 BOSTON ST, CHICAGO HEIGHTS, IL 604114026 (Tel: 7082693333)

πŸ“
Updated Business Mailing Address September 30, 2019

Registered at 277 BOSTON ST, CHICAGO HEIGHTS, IL 604114026 (Tel: 7082693333)

βœ…
NPI Profile Active April 17, 2017

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 17, 2017

Registered at 22232 ROCKINGHAM RD, RICHTON PARK, IL 604711119 (Tel: 7082004979)

πŸ“
Business Mailing Address (Initial Record) April 17, 2017

Registered at 22232 ROCKINGHAM RD, RICHTON PARK, IL 604711119 (Tel: 7082004979)

πŸ‘€
Provider Name / Credentials (Initial Record) April 17, 2017

Recorded as MALCOLM LEE

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 17, 2017

Specialist/Technologist, Pathology

🟒
Initial NPI Registration & Enumeration April 17, 2017

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1659805521
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 17, 2017
Last Update: August 05, 2024
Sole Proprietor: Yes

Mailing Address

344 Victory Dr

Park Forest, IL 604662003

Phone: 7084903340

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.